Cherrydale Pediatrics — Laura Kobler, MSN, CPNP-PC
Effective Date: March 18, 2026
Cherrydale Pediatrics is committed to protecting the privacy of your child's health information. We are required by law to:
We may use and disclose your child's health information for the following purposes:
We may use and disclose health information to provide medical treatment and services to your child. For example:
We may use and disclose health information to bill and collect payment for services. For example:
We may use and disclose health information for healthcare operations. For example:
We may use and disclose health information when required by federal, state, or local law.
We may disclose health information to public health authorities for purposes such as:
We may disclose health information to health oversight agencies for activities authorized by law, such as audits, investigations, and inspections.
We may disclose health information in response to a court or administrative order, subpoena, discovery request, or other lawful process.
We may disclose limited health information to law enforcement officials for purposes such as:
We may use and disclose health information when necessary to prevent a serious and imminent threat to the health or safety of your child or others.
We may disclose health information to coroners, medical examiners, and funeral directors as necessary to carry out their duties.
We will obtain your written authorization before using or disclosing your child's health information for purposes other than treatment, payment, healthcare operations, or other purposes described in this Notice. You may revoke your authorization in writing at any time.
Uses and disclosures that require your authorization may include but are not limited to:
If your child's health information is disclosed to a third party, it may be subject to redisclosure by that third party and may no longer be protected by this Notice.
You have the right to inspect and obtain a copy of your child's medical records. To request copies, submit a written request to Cherrydale Pediatrics. We may charge a reasonable fee for copying and mailing costs.
If you believe your child's health information is incorrect or incomplete, you may request an amendment. We may deny your request if the information:
You have the right to request an accounting of certain disclosures of your child's health information made by us during the six years prior to your request.
You have the right to request restrictions on how we use or disclose your child's health information for treatment, payment, or healthcare operations. We are not required to agree to your request, but if we do, we will comply with the restriction unless the information is needed for emergency treatment.
You have the right to request that we communicate with you about your child's health information by alternative means or at alternative locations. We will accommodate reasonable requests.
You have the right to obtain a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
We are required by law to maintain the privacy of protected health information and to notify you in the event of a breach of your child's unsecured protected health information.
You have the right to file a complaint with Cherrydale Pediatrics or with the U.S. Department of Health and Human Services Office for Civil Rights if you believe your privacy rights have been violated. You will not be retaliated against for filing a complaint.
We reserve the right to change this Notice at any time. The revised Notice will apply to all health information we maintain. We will post the current Notice on our website and will provide you with a copy upon request. We are required to abide by the terms of the notice currently in effect.
If you have questions about this Notice or wish to exercise any of your rights, please contact:
Cherrydale Pediatrics
Privacy Officer: Laura Kobler
Phone: (571) 240-4884
Email: info@cherrydalepediatrics.com